Health Plan Weekly
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COVID Booster Campaign Could Prevent Thousands of Deaths, Save Billions in Medical Costs
With the updated bivalent COVID-19 boosters available, federal investment in vaccination campaigns could save thousands of people from hospitalizations and deaths and avert billions of dollars in medical costs, The Commonwealth Fund predicted.
The study projected three scenarios: a baseline scenario where vaccination rates remain at the average rate in August 2022 — about 28 doses per 100,000 people per day — from September 2022 to March 2023. In the first vaccination campaign scenario, COVID booster uptake by the end of 2022 reaches the same level as influenza vaccination coverage seen in 2020–2021, and then remains at the baseline rate until the end of March 2023. This could prevent more than 75,000 deaths and generate $44 billion in medical cost savings over the course of the next six months, compared with the baseline scenario.
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News Briefs: UnitedHealth 3Q Earnings Beat Wall Street Expectations
UnitedHealth Group on Oct. 14 reported adjusted earnings per share of $5.79, beating the Wall Street consensus estimate of $5.43. Driving that result was UnitedHealth’s medical loss ratio of 81.6%, which was meaningfully lower than the consensus estimate of 82.4%. The company's “solid performance was largely broad-based with both UHC [insurance division UnitedHealthcare] and Optum beating our segment earning estimates by 13.2% and 1.7%, respectively,” SVB Securities analyst Whit Mayo advised investors.
The Biden administration on Oct. 11 released its final rule fixing the so-called “family glitch” in the Affordable Care Act. A 2021 Kaiser Family Foundation analysis estimated that 5.1 million people fall into the family glitch, which “occurs when a worker receives an offer of affordable employer coverage for themselves but not for their dependents, making them ineligible for financial assistance for marketplace coverage.” In a statement on the final rule, HHS Secretary Xavier Becerra said that the final rule “resolves a flaw in prior ACA regulations to bring more affordable coverage to about one million Americans. Our goal is simple: leave no one behind and give everyone the peace of mind that comes with health insurance.”
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Medicaid MCOs Will Aid Ambitious New Waiver Demos in Massachusetts, Oregon
Recently, the Biden administration approved a pair of wide-ranging Medicaid waiver demonstration programs in Massachusetts and Oregon, granting those states authority to test unique policies such as keeping certain populations enrolled in Medicaid for more than a year and covering clinically tailored housing and nutritional supports. Medicaid managed care plans that serve Massachusetts and Oregon tell AIS Health that they’re planning to play a major role in helping to implement the new waiver programs, which will allow them to expand some of the social-needs-based interventions that they’re already providing and reduce the enrollee churn that can stymie care-management efforts.
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Privately Insured Individuals Are Still at Risk of Medical Debt, Financial Concerns
People with private health insurance are just about as likely to have medical debt as the U.S. population as a whole, according to a study published on Sept. 16 in JAMA Network Open. Lead study author David U. Himmelstein, M.D., tells AIS Health, a division of MMIT, that the results suggest that health insurers could do more to protect enrollees from financial hardship.
The authors examined more than 135,000 people who completed the U.S. Census Bureau’s Surveys of Income and Program Participation (SIPP) from 2017 to 2019. During that time, 10.8% of individuals carried medical debt, including 10.5% of privately insured and 15.3% of uninsured people.
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A Large Share of American Households Still Struggle With Paying Medical Bills
About 42% of working-age adults said they had problems paying medical bills or were paying off medical debt, according to findings from the 2022 Commonwealth Fund Biennial Health Insurance Survey. With 43% of the respondents inadequately insured, medical costs and debt remained a major concern for many Americans. Almost one-third of adults who were underinsured — whose coverage did not provide them with affordable access to health care — reported they were contacted by a collection agency regarding unpaid medical bills. Of those with medical debt, 56% said the amount reached $2,000 or more.
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